13 PAIRS OF RIBS - A PREDICTOR OF LONG GAP ATRESIA IN TRACHEOESOPHAGEAL FISTULA

Background/Purpose: Results of treatment of tracheoesophageal fistula (TEF) have improved over the years. However, long gap atresias continu e to be a problem and require modification in the conventional operati on, Preoperative diagnosis of a long gap atresia in a case of TEF is d ifficult, and often the defect is noted only at thoracotomy, thus nece ssitating multiple intraoperative changes in the position of the neona te. In the past 5 years the authors have treated 61 cases of TEF, Of t hese, 12 had a long gap atresia, Nine of these 12 patients had 13 pair s of ribs, None of the patients with a short gap atresia had 13 pairs of ribs. Hence, the presence of 13 pairs of ribs is a good indicator o f long gap atresia. In a child who has TEF with 13 pairs of ribs, suit able modifications in operative procedure can be planned. The report a lso discusses the possible embryological basis of this association. Co pyright (C) 1997 by W.B. Saunders Company.